AHIP Final Exam 2025/2026 – Updated Questions and Revised Answers | 100% Guarantee Pass

AHIP2025Final ExamUpdatedQuestionsand
Verified Answers, 100% Guarantee Pass



Mrs. Shields is covered by Original Medicare. She sustained a hip fracture
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hand is being successfully treated for that condition. However, she and her
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hphysicians feel that after her lengthy hospital stay, she will need a month or
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htwo of nursing and rehabilitative care. What should you tell them about
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hOriginal Medicare's coverage of care in a skilled nursing facility?
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- correct answer - Medicare will cover Mrs. Shield's skilled nursing services
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provided during the first 20 days of her stay, after which she would have a
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hcopay until she has been in the facility for 100 days.
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Mrs. West wears glasses and dentures and has enjoyed considerable pain
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hrelief from arthritis through massage therapy. She is concerned about
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whether or not Medicare will cover these items and services. What should
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hyou tell her?
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- correct answer - Medicare does not cover massage therapy,or, in general,
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hglasses or dentures. h h




Mrs. Parkis anelderly retiree. Mrs. Parkhasa lowfixed income. Whatcould
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hyou tell Mrs. Park that might be of assistance?
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- correct answer - She should contact her state Medicaid agency to see if
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she qualifies for one of several programs that can help with Medicare costs
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hfor which she is responsible.
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Mr. Alonso receives some help paying for his two generic prescription
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hdrugs from his employer's retiree coverage, but he wants to compare it to a
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hPart D prescription drug plan. He asks you what costs he would generally
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hexpect to encounter when enrolling into a standard Medicare Part D
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hprescription drug plan. What should you tell him? h h h h h h h




- correct answer - He generally would pay a monthly premium, annual
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hdeductible, and per-prescription cost-sharing. h h h




Mrs. Gonzalez is enrolled in Original Medicare andhasa Medigap policy as
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hwell, but it provides no drug coverage. She would like to keep the coverage
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she has but replace her existing Medigap plan with one that provides drug
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coverage. What should you tell her? h h h h h




- correct answer - Mrs. Gonzalez cannot purchase a Medigap plan that
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covers drugs, but she could keep her Medigap policy and enroll in a Part D
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hprescription drug plan. h h




Mr. Davis is 52 years old and has recently been diagnosed with end-stage
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hrenal disease (ESRD) and will soon begin dialysis. He is wondering if he can
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hobtain coverage under Medicare. What should you tell him?
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- correct answer h r
He may sign-up for Medicare at any time
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-
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h however

coverage usually begins on the fourth month after dialysis treatments start.
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Mrs. Duarteis enrolled in OriginalMedicare Parts A and B. Shehasrecently
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hreviewed her Medicare Summary Notice (MSN) and disagrees with a
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hdetermination that partially denied one of her claims for services. What
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hadvice would you give her? h h h h




- correct answer - Mrs. Duarte should file an appeal of this initial
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determinationwithin 120 days ofthedate she received the MSN in themail.
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Mrs. Geisler's neighbor told her she should look at her Part D
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h options during the annual Medicare enrollment period because the features of
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hPart

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D might have changed. Mrs. Geisler can't remember what Part D is so she
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called you to ask what her neighbor was talking about. What could you tell
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hher?

- correct answer - Part D covers prescription drugs and she should look at
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her premiums, formulary, and cost-sharing among other factors to see if
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hthey have changed.
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Mr. Rainey is experiencing paranoid delusions and his physician feels that he
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hshould be hospitalized. What should you tell Mr. Rainey (or his
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hrepresentative) about the length of an inpatient psychiatric hospital stay
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hthat Medicare will cover?
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- correct answer - Medicare will cover a total of 190 days of inpatient
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hpsychiatric care during Mr. Rainey's entire lifetime.
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Mr. Xi will soon turn age 65 and has come to you for advice as to what
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hservices are provided under Original Medicare. What should you tell Mr. Xi
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hthatbest describes the healthcoverage provided to Medicare beneficiaries?
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- correct answer - Beneficiaries under Original Medicare have no
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hcost-sharing for most preventive services. h h h h




Mr. Singh would like drug coverage but does not want to be enrolled in a
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